Provider Demographics
NPI:1023287109
Name:DAVID P. CARTAGO D.D.S., INC
Entity type:Organization
Organization Name:DAVID P. CARTAGO D.D.S., INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:CARTAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-634-9118
Mailing Address - Street 1:9260 ALCOSTA BLVD
Mailing Address - Street 2:SUITE B10
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4134
Mailing Address - Country:US
Mailing Address - Phone:925-634-9118
Mailing Address - Fax:925-634-9102
Practice Address - Street 1:4510 OHARA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2293
Practice Address - Country:US
Practice Address - Phone:925-634-9118
Practice Address - Fax:925-634-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty